体外膜肺在急性呼吸窘迫综合征治疗中的应用

Application of extracorporeal membrane oxygenation in the treatment of acute respiratory distress syndrome

急性呼吸窘迫综合征（ARDS）是儿科危重症病死率很高的疾病之一，体外膜肺（ECMO）是抢救重症ARDS的一种有效治疗方法，临床上用于经包括机械通气在内的传统治疗无效的ARDS患者。ECMO原理为通过体外循环方式进行心肺功能支持，以充分的氧输送来达到心肺支持作用。由于ECMO的生命支持属性，其疗效也受到病情及原发病等因素的影响，文献报道儿童ARDS存活率为40％～78％。ECMO的有创性、持续抗凝、严重并发症、高治疗成本等因素是限制其广泛应用的重要因素。

Acute respiratory distress syndrome（ARDS） is a critical illness in children with high mortality. Ex- tracorporeal membrane oxygenation （ECMO） is an effective rescue method for the severe ARDS, and is usually used in ARDS patient who does not respond to conventional respiratory support including mechanical ventilation. The principle of ECMO is to afford a cardiopulmonary bypass support and gives enough blood oxygen delivery. The effectiveness of ECMO on ARDS is influenced by the severity and causes of the sickness because of its respiratory support character. The reported survival rate of the ECMO children with ARDS ranged from 40% to 78%. The traumatic procedure,need anticoagulation, noted complication and treatment cost are the important factors that restrain ECMO at the rescue role.